Provider Demographics
NPI:1629715586
Name:FARMER, KRYSTIN D (OTA)
Entity Type:Individual
Prefix:
First Name:KRYSTIN
Middle Name:D
Last Name:FARMER
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 S GORDON ST
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:MO
Mailing Address - Zip Code:64020-8304
Mailing Address - Country:US
Mailing Address - Phone:660-924-8175
Mailing Address - Fax:
Practice Address - Street 1:4301 MADISON AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3491
Practice Address - Country:US
Practice Address - Phone:816-931-4277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant